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While conventional ion-soft landing uses the mass-to-charge (m/z) ratio to achieve molecular selection for deposition, here we demonstrate the use of Structures for Lossless Ion Manipulation (SLIM) for mobility-based ion selection and deposition. The dynamic rerouting capabilities of SLIM were leveraged to enable the rerouting of a selected range of mobilities to a different SLIM path (rather than MS) that terminated at a deposition surface. A selected mobility range from a phosphazene ion mixture was rerouted and deposited with a current pulse (â¼150 pA) resembling its mobility peak. In addition, from a mixture of tetra-alkyl ammonium (TAA) ions containing chain lengths of C5-C8, selected chains (C6, C7) were collected on a surface, reconstituted into solution-phase, and subsequently analyzed with a SLIM-qToF to obtain an IMS/MS spectrum, confirming the identity of the selected species. Further, this method was used to characterize triply charged tungsten-polyoxometalate anions, PW12O403- (WPOM). The arrival time distribution of the IMS/MS showed multiple peaks associated with the triply charged anion (PW12O403-), of which a selected ATD was deposited and imaged using TEM. Additionally, the identity of the deposited WPOM was ascertained using energy-dispersive (EDS) spectroscopy. Further, we present theory and computations that reveal ion landing energies, the ability to modulate the energies, and deposition spot sizes.
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AIMS: This study aimed to examine the impact of deep-learning reconstruction (DLR) on zero echo time (ZTE) lung MRI. MATERIALS AND METHODS: Fifty-nine patients who underwent both chest CT and ZTE lung magnetic resonance imaging (MRI) were enrolled. Noise reduction in ZTE lung MRI was compared using various DLR intensities (DLR-M, DLR-H) and conventional image filtering techniques (NF1 â¼ NF4). The normalized noise power spectrum (NPS) was analysed through phantom experiments. Image sharpness was evaluated using a blur metric. We compared subjective image quality and the detection of sub-centimetre nodules and emphysema between the original and noise-reduced images. Statistical analyses included the Wilcoxon signed-rank and McNemar's tests, with inter-reader agreement assessed via Kappa coefficients. RESULTS: NPS peaks were lower in NF1 through NF4, DLR-M, and DLR-H compared to the original images. While the average spatial frequency of the NPS shifted towards lower frequencies with increasing NF levels, it remained unchanged with DLR. Blur metric values of NF1â¼NF4 were significantly higher than those of the original images (p<0.008). However, there were no significant differences in blur metric values between DLR-M, DLR-H, and the original images. Image quality was rated highest for DLR-H, with a statistically significant improvement over the original (p<0.05). DLR-H showed higher diagnostic confidence for detecting sub-centimetre nodules than the original images. DLR-H showed higher diagnostic performance than the original for detecting emphysema. CONCLUSIONS: DLR can improve ZTE lung MRI quality while preserving image texture and sharpness, thereby enhancing the potential of ZTE for evaluating pulmonary parenchymal disease.
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OBJECTIVES: Depression is related to increased risk for dementia, possibly through links with cerebrovascular disease. Blood pressure variability is an emerging risk factor for cerebrovascular disease and dementia, but relationships with affective symptoms remain understudied. DESIGN: Retrospective analysis of prospective cohort study. SETTING: Alzheimer's Disease Neuroimaging Initiative. PARTICIPANTS: 505 older adults without history of dementia or recent depression underwent three to four blood pressure measurements over 12 months and completed a self-report measure of depressive symptoms (Geriatric Depression Scale - 15 Item) at study baseline and 24-months follow-up. MEASUREMENTS: Blood pressure variability was calculated as variability independent of mean and maximum minus minimum. Regression models investigated relationships between blood pressure variability and severity of self-reported depressive symptoms at 24-months follow-up after controlling for several variables, including average blood pressure, antihypertensive use, antidepressant use, and baseline depressive symptom severity. RESULTS: Elevated diastolic blood pressure variability was related to greater total depressive symptom score at follow-up (ß = .16 [95% CI 0.02, .30]; p = 0.03), with specific contribution from increased severity of symptoms of dysphoria (odds ratio = 1.35 [95% CI 1.07, 1.75]; p = 0.02). Blood pressure variability was not significantly related to other symptom subscales, including those reflecting life satisfaction or withdrawal. CONCLUSIONS: Findings suggest that elevated diastolic blood pressure variability is related to subthreshold depressive symptomatology in older adults without history of dementia or recent depression, independent of average blood pressure. Blood pressure variability may be an understudied vascular risk factor linked with depression and cognitive impairment, with potential therapeutic implications.
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Doença de Alzheimer , Transtornos Cerebrovasculares , Idoso , Pressão Sanguínea , Depressão/diagnóstico , Humanos , Estudos Prospectivos , Estudos RetrospectivosRESUMO
A major challenge in studies relating built environment features to health is measurement error in exposure due to geocoding errors. Faulty geocodes in built environment data introduce errors to exposure assessments that may induce bias in the corresponding health effect estimates. In this study, we examine the distribution of the measurement error in measures constructed from point-referenced exposures, quantify the extent of bias in exposure effect estimates due to geocode coarsening, and extend the simulation extrapolation (SIMEX) method to correct the bias. The motivating example focuses on the association between children's body mass index and exposure to the junk food environment, represented by the number of junk food outlets within a buffer area near their schools. We show, algebraically and through simulation studies, that coarsening of food outlet coordinates results in exposure measurement errors that have heterogeneous variance and nonzero mean, and that the resulting bias in the health effect can be away from the null. The proposed SC-SIMEX procedure accommodates the nonstandard measurement error distribution, without requiring external data, and provides the best bias correction compared to other SIMEX approaches.
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Algoritmos , Mapeamento Geográfico , Viés , Ambiente Construído , Criança , Simulação por Computador , HumanosRESUMO
OBJECTIVES: Body mass index (BMI) is a known indicator of all-cause mortality. However, conventional BMI does not reflect the three-dimensional human body. To overcome this limitation, a new BMI has been proposed that provides a closer approximation of real human body shape. This study investigated the associations between the new BMI and poor outcomes in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). METHOD: We retrospectively reviewed the medical records of 242 patients with AAV in a single tertiary medical center. Based on the new BMI, the patients were categorized into four groups: underweight (<18.5 kg/m2.5 ), healthy weight (18.5 to <25.0 kg/m2.5 ), overweight (25.0 to <30.0 kg/m2.5 ), and obese (≥30.0 kg/m2.5 ). The association among the new BMI and death, relapse, end-stage renal disease (ESRD) development, cerebrovascular accident, and cardiovascular disease was analyzed. RESULTS: The underweight group, according to the new BMI, had higher hazard ratios (HRs) for all-cause mortality (HR: 3.180, 95% confidence interval [CI]: 1.134-8.922, p = 0.028), relapse (HR: 2.141, 95% CI: 1.019-4.368, p = 0.036), and ESRD development (HR: 2.729, 95% CI: 1.190-6.259, p = 0.018) than the healthy weight group. However, according to the conventional BMI, there were no differences in the risks for all poor outcomes between the underweight and healthy weight groups. Multivariate logistic regression analysis demonstrated that being underweight, according to the new BMI, was an independent risk factor for all-cause mortality (HR: 5.285; 95% CI: 1.468-19.018; p = 0.011). CONCLUSION: Being underweight, according to the new BMI, is associated with poor outcomes in patients with AAV.
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Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos , Falência Renal Crônica , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/epidemiologia , Anticorpos Anticitoplasma de Neutrófilos , Índice de Massa Corporal , Feminino , Humanos , Masculino , Prognóstico , Recidiva , Estudos Retrospectivos , Magreza/complicações , Magreza/epidemiologiaRESUMO
We present a C-band 6-mode 7-core fiber amplifier in an all-fiberized cladding-pumped configuration for space division multiplexed transmission supporting a record 42 spatial channels. With optimized fiber components (e.g. passively cooled pump laser diode, pump coupler, pump stripper), high power multimode pump light is coupled to the active fiber without any noticeable thermal degradation and an average gain of 18 dB and noise figure of 5.4 dB are obtained with an average differential modal gain of 3.4 dB.
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Low phase angle, a non-invasive bioimpedance marker, is associated with elevated odds of dysmobility syndrome and its components. Phase angle (estimated cutoffs: < 4.8° in men; < 4.5° in women) can be used to detect dysmobility syndrome in community-dwelling older adults as a simple, integrative screening tool. INTRODUCTION: Dysmobility syndrome uses a score-based approach to predict fracture risk that incorporates the concepts of osteoporosis, sarcopenia, and obesity. Low phase angle (PhA), a simple, non-invasive bioelectrical impedance marker, was associated with low lean mass, high fat mass, and poor muscle function. We aimed to investigate the association between PhA and dysmobility syndrome, with the exploration of the diagnostic cutoffs. METHODS: In a community-dwelling Korean older adult cohort, dysmobility syndrome was defined as the presence of ≥ 3 of the following components: osteoporosis, low lean mass, falls in the preceding year, low grip strength, high fat mass, and poor timed up and go performance. RESULTS: Among the 1825 participants (mean age 71.6, women 66.7%), subjects were classified into sex-stratified PhA tertiles. The prevalence of dysmobility syndrome increased from the highest PhA tertile group to the lowest (15.50 to 2.45% in men; 33.41 to 12.25% in women, P for trend < 0.001). The mean PhA values decreased as the dysmobility score increased (5.33° to 4.65° in men; 4.76° to 4.39° in women, P for trend < 0.001). Low PhA (cutoff: < 4.8° in men; < 4.5° in women) was associated with twofold elevated odds of dysmobility syndrome after adjusting for age, sex, and conventional risk factors. Low PhA improved the identification of individuals with dysmobility syndrome when added to the conventional risk model (area under the curve, 0.73 to 0.75, P = 0.002). CONCLUSION: Low PhA was associated with dysmobility syndrome and its components, independent of age, sex, body mass index, nutritional status, and inflammation.
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Osteoporose , Sarcopenia , Idoso , Feminino , Humanos , Vida Independente , Masculino , Osteoporose/diagnóstico , Osteoporose/epidemiologia , República da Coreia/epidemiologia , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia , SíndromeRESUMO
OBJECTIVE: To examine the concordance rate of non-chromosomal congenital malformations in twin pairs based on zygosity. DESIGN: Retrospective cohort study. SETTING: A tertiary hospital in Korea. POPULATION: Twin pairs born at Seoul National University Hospital between 2001 and 2019. METHODS: Congenital malformations were diagnosed by postnatal workups of neonates or autopsy in cases of stillborn infants. Zygosity was confirmed by sex, chorionicity and DNA analysis. MAIN OUTCOME MEASURES: Concordance rate of congenital malformations in twin pairs based on zygosity. RESULTS: In total, 3386 twin pairs were included. The risk of a congenital malformation in the index twin increased significantly if the co-twin had the congenital malformation, and the concordance rate was higher in monozygotic (MZ) than in dizygotic (DZ) twins (37.04 versus 16.77, P < 0.001). An increased risk of a congenital malformation in the presence of the same congenital malformation in the co-twin was observed only for malformations of the nervous system, eye/ear/face/neck, circulatory system, cleft lip/palate, genital organs, urinary system and musculoskeletal system. Significantly higher concordance rates in MZ than in DZ twin pairs were observed only for the nervous system (40.00 versus 0.00, P < 0.001), circulatory system (32.97 versus 19.74, P = 0.021), cleft lip/palate (44.44 versus 0.00, P = 0.017) and urinary system (22.22 versus 0.00, P = 0.004), whereas significant differences were not found for the genital organs or musculoskeletal system. CONCLUSIONS: Monozygotic twins had higher concordance rates than DZ twins only in specific organ systems. It may be speculated that nervous system, circulatory system, cleft lip/palate and urinary system are primarily genetically affected. TWEETABLE ABSTRACT: Monozygotic twins had higher concordance rates than dizygotic twins only in specific organ systems.
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Anormalidades Congênitas/genética , Doenças em Gêmeos/genética , Gêmeos Dizigóticos/genética , Gêmeos Monozigóticos/genética , Anormalidades Congênitas/diagnóstico , Doenças em Gêmeos/diagnóstico , Feminino , Predisposição Genética para Doença , Testes Genéticos , Humanos , Recém-Nascido , Masculino , Estudos Retrospectivos , Fatores de RiscoRESUMO
BACKGROUND AND AIMS: Oxidative stress contributes to development of diabetic nephropathy. We implicated SH3YL1 in oxidative stress-induced inflammation and examined whether SH3YL1 could be used as a new biomarker of diabetic nephropathy. METHODS AND RESULTS: In this study, we investigated the relationship between plasma level of SH3YL1 and diabetic nephropathy in patients with type 2 diabetes. In addition, we examined the physiological role of SH3YL1 in db/db mice and cultured podocytes. Plasma SH3YL1 concentration was significantly higher in patients with diabetes than in controls, even in normoalbuminuric patients, and was markedly increased in the macroalbuminuria group. Plasma SH3YL1 level was positively correlated with systolic blood pressure, HOMA-IR, postprandial blood glucose, plasma level of retinol binding protein 4 (RBP 4), and urinary albumin excretion (UAE) and was inversely correlated with BMI. Regression analysis showed that plasma level of RBP 4, UAE, and BMI were the only independent determinants of plasma SH3YL1 concentration. In db/db mice, plasma and renal SH3YL1 levels were significantly increased in mice with diabetes compared with control mice. In cultured podocytes, high glucose and angiotensin II stimuli markedly increased SH3YL1 synthesis. CONCLUSION: These findings suggest that plasma level of SH3YL1 offers a promising new biomarker for diabetic nephropathy.
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Albuminúria/sangue , Diabetes Mellitus Tipo 2/sangue , Nefropatias Diabéticas/sangue , Proteínas de Membrana/sangue , Adulto , Idoso , Albuminúria/diagnóstico , Albuminúria/etiologia , Animais , Biomarcadores/sangue , Estudos de Casos e Controles , Linhagem Celular , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico , Nefropatias Diabéticas/diagnóstico , Nefropatias Diabéticas/etiologia , Modelos Animais de Doenças , Feminino , Humanos , Masculino , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Podócitos/metabolismo , Proteínas Plasmáticas de Ligação ao Retinol/metabolismo , Regulação para CimaRESUMO
Probiotics play an important role in health benefits on the host. However, they also possess potentials for infectivity or in situ toxin production; thus, requiring a comprehensive assessment of their safety. In this study, we report genomic characteristics of a newly isolated Lactobacillus casei IDCC 3451 from infant faeces. Phenotypic assays based on enzyme activities and carbohydrate fermentation profiles represented metabolic features of the strain. Safety evaluation for antimicrobial resistance, biogenic amines production and cytotoxicity to a murine mouse model suggested its safe use as a probiotic strain. Our findings on the genetic background of L. casei IDCC 3451 and its potential features provide a promising functional and safe probiotic strain for the human consumption.
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Genoma Bacteriano/genética , Lacticaseibacillus casei/genética , Lacticaseibacillus casei/metabolismo , Probióticos/efeitos adversos , Probióticos/farmacologia , Animais , Antibacterianos/farmacologia , Farmacorresistência Bacteriana/genética , Fezes/microbiologia , Fermentação , Genômica , Humanos , Lactente , Lacticaseibacillus casei/isolamento & purificação , CamundongosRESUMO
The effect of anti-resorptive drug (ARD) usage among patients with successful dental implant osseointegration is controversial. This study showed an increased risk of implant failure in ARD users. Risk factors included pre-existing marginal bone loss, overdenture, diabetes, and a short interval between implant placement and ARD administration. INTRODUCTION: This retrospective study aimed to determine whether anti-resorptive drug (ARD) usage increased risk of implant failure among patients with successful implant osseointegration. Additionally, the study investigated risk factors that affected implant survival rate in ARD users. METHODS: Eighty ARD users with 344 implants who had more than 12 months of follow-up from the initiation of ARD treatment during the period between 2008 and 2017 were included, along with 80 non-ARD users from the same period. The primary outcome was dental implant survival. Kaplan-Meier survival curves and Cox proportional hazard models were used for survival analysis. RESULTS: Average follow-up was 85.3 months. Implant survival rates were 89.83% in ARD users and 96.03% in non-ARD users. In the univariate Cox proportional hazard model, risk of implant failure was significantly higher in patients with pre-existing marginal bone loss (MBL), diabetes, and concurrent bone augmentation. However, risk of implant failure was significantly lower when the interval between implant placement and ARD administration was < 36 months. Compared with overdenture, single crown and fixed splinted users had lower risk of implant failure. In multivariate analysis, variables including pre-existing MBL, diabetes, < 36-month interval between implant placement and ARD treatment, and usage of fixed splinted prosthesis were significantly associated with increased risk of implant failure. CONCLUSIONS: ARD administration after implant osseointegration was correlated with a reduced implant survival rate. Pre-existing MBL, diabetes, type of final prosthesis, and the interval between implant placement and initiation of ARD administration influenced risk of implant failure.
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Implantes Dentários , Peri-Implantite , Preparações Farmacêuticas , Implantes Dentários/efeitos adversos , Seguimentos , Humanos , Osseointegração , Peri-Implantite/etiologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
BACKGROUND & AIMS: Regorafenib demonstrated a clinical benefit for patients with unresectable hepatocellular carcinoma (uHCC) in the phase III RESORCE trial. Considering the heterogeneity of uHCC and discrepancies in its characteristics between prospective trials and daily practice, real-life evidence is necessary. METHODS: This multicentre, retrospective analysis was performed by the Korean Cancer Study Group. In total, 440 patients who received regorafenib between January 2017 and November 2019 were identified in nine tertiary referral hospitals in Korea. RESULTS: All patients received prior sorafenib, and the median time-to-progression (TTP) on sorafenib was 3.9 months (range, 0.2-71.6). Regorafenib was used as the second, third and fourth to seventh lines of therapy in 305 (69.3%), 115 (26.1%) and 20 (4.5%) patients respectively. According to the RECIST v1.1, the overall response rate was 7.7% (n = 34), and the median progression-free survival (PFS) and overall survival (OS) were 3.2 (95% CI, 2.8-3.5) and 12.1 (95% CI, 9.7-14.5) months respectively. Immune checkpoint inhibitors (ICIs) were given in 115 patients (26.1%) prior to regorafenib. There were no differences in PFS and OS with regorafenib according to the prior use of ICIs (PFS, P = .61; OS, P = .63). The occurrence of hand-foot skin reaction (HFSR) was associated with a better OS (P < .001). CONCLUSIONS: The real-life clinical outcomes of regorafenib for patients who progressed on prior systemic therapy including ICIs were consistent with the phase III trial results. HFSR was significantly associated with better OS with regorafenib.
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Carcinoma Hepatocelular , Neoplasias Hepáticas , Carcinoma Hepatocelular/tratamento farmacológico , Humanos , Imunoterapia , Neoplasias Hepáticas/tratamento farmacológico , Compostos de Fenilureia/efeitos adversos , Estudos Prospectivos , Piridinas , República da Coreia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
BACKGROUND AND PURPOSE: The objective of this study was to investigate the association between body mass index (BMI) and both initial stroke severity at presentation and functional outcomes after acute ischaemic stroke (AIS) in patients with non-valvular atrial fibrillation (NVAF). METHODS: Patients were categorized on the basis of their BMI into underweight (BMI <18.5, n = 111), normal (18.5 ≤ BMI <25, n = 1036) and overweight to obese (BMI ≥25, n = 472) groups. Initial stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) score and functional outcomes were assessed using the modified Rankin Scale score at discharge. The differences in stroke severity and functional outcomes were compared between groups using robust log-linear regression with a Poisson distribution and binary logistic regression analysis. RESULTS: A total of 1619 AIS patients with NVAF from six hospitals were included. Compared with the NIHSS scores [median 5, interquartile range (IQR) 2-14] of normal-weight patients, the NIHSS scores (median 9, IQR 4-19) of underweight patients were more likely to be higher, whereas those of overweight to obese patients were lower (median 4, IQR 1-12) (P < 0.001). In terms of functional outcomes after stroke, underweight patients had a higher risk of poor functional outcomes (odds ratio 1.78, 95% confidence interval 1.09-2.56, P = 0.01) but overweight to obese patients had no significant difference in functional outcomes compared with normal-weight patients. CONCLUSION: An inverse association was found between BMI and stroke severity in AIS patients with NVAF. This suggests the presence of an obesity paradox for short-term outcomes in patients with NVAF.
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Fibrilação Atrial , Isquemia Encefálica , AVC Isquêmico , Fibrilação Atrial/complicações , Fibrilação Atrial/epidemiologia , Índice de Massa Corporal , Isquemia Encefálica/complicações , Isquemia Encefálica/epidemiologia , Humanos , Fatores de RiscoRESUMO
BACKGROUND AND PURPOSE: Hearing loss (HL) is one of the most influential risk factors of dementia in older adults. However, its potential association with neurodegeneration is not well established. The association between HL and cortical thickness in cognitively normal older adults was evaluated. METHODS: In all, 982 cognitively normal older adults (age ≥65 years) were identified from the Health Promotion Center at the Samsung Medical Center from September 2008 to December 2014. The participants underwent pure-tone audiometry and brain magnetic resonance imaging. HL was evaluated according to a four-frequency (0.5, 1, 2, 4 kHz) pure-tone average. Participants were divided into three groups according to pure-tone average (normal hearing ≤15 dB, minimal HL 16-25 dB, mild-to-severe HL >25 dB). Cortical thickness in the HL groups was compared with that of the normal hearing group. RESULTS: In women, right ear HL was associated with cortical thinning: the minimal HL group showed cortical thinning in the left frontal and bilateral occipital areas and the mild-to-severe HL group showed cortical thinning in the bilateral frontal, right temporal and bilateral occipital areas compared to the normal hearing group. In men, there was no significant association between HL on either side and cortical thickness. CONCLUSION: In older women, right ear HL is associated with neurodegeneration even in a cognitively normal state. Therefore, managing HL especially in older women may be an effective strategy for dementia prevention.
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Afinamento Cortical Cerebral , Perda Auditiva , Idoso , Audiometria de Tons Puros , Encéfalo , Feminino , Perda Auditiva/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , MasculinoRESUMO
BACKGROUND: The aim of this study was to compare olfactory function change in patients who underwent endoscopic skull-base surgery. METHODOLOGY: A total of 928 patients were included in this retrospective study. Olfactory function was measured using the non- validated Likert scale (0â"100), the Cross-Cultural Smell Identification Test (CC-SIT) and the butanol threshold test (BTT). Patients were divided into two groups: an endoscopic trans-sellar approach group (ETA, n = 768) and an extended endoscopic endonasal approach group (EEEA, n = 160). The ETA group was sub-divided into Nasoseptal flap (NSF) and no NSF groups. RESULTS: Non-validated olfactory function significantly worsened in the EEEA and ETA-NSF groups compared with that in the ETA- no NSF group for at least 6 months post-operatively. Validated olfactory impairment (BTT and CC-SIT) was also significantly worse in the EEEA and NSF groups compared with that in the ETA-no NSF group 3 months post-operatively. Additionally, the degrees of non-validated and validated olfactory deterioration were not significantly different between the EEEA and ETA-NSF groups. We also found that CC-SIT score changes were significantly impaired in tuberculum sellae meningioma patients than in craniopharyn- gioma patients. CONCLUSIONS: We conclude that NSF was the key factor that led to olfactory impairment after endoscopic skull-base surgery.
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Transtornos do Olfato , Procedimentos de Cirurgia Plástica , Humanos , Transtornos do Olfato/etiologia , Estudos Retrospectivos , Fatores de Risco , Base do Crânio/cirurgia , OlfatoRESUMO
Gastric cancer is the fourth most common cancer worldwide. Despite the high incidence of gastric cancer, efficient chemotherapy treatments still need to be developed. In this study, we examined the anticancer effects of endoplasmic reticulum (ER) stress inducer tunicamycin in gastric cancer. Previously, we found that overexpression of WLS1/GPR177 correlated with poor prognosis in patients with gastric cancer. Furthermore, tunicamycin treatment downregulated GPR177 expression in a dose-dependent manner. GPR177 transports WNT ligand from ER to the plasma membrane, mediating its secretion to the extracellular matrix. In gastric cancer cells, GPR177 preferentially localizes to the ER. Small interfering RNA-mediated knockdown of GPR177 leads to sensitization to ER stress and induces apoptosis of cancer cells along with tunicamycin treatment. GPR177 suppression promoted the ER stress-mediated proapoptotic pathway, such as PERK-CHOP cascade. Furthermore, fluorouracil treatment combined with tunicamycin dramatically reduced cancer cell proliferation. Efficacy of tunicamycin chemotherapy treatments depended on GPR177 expression in gastric cancer cell lines. Together, our results indicate that ER stress can potentiate anticancer effects and suggest GPR177 as a potential gastric cancer therapeutic target.
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AIM: To compare the diagnostic performance of abbreviated magnetic resonance imaging (MRI) and full diagnostic MRI with computer-aided diagnosis (CAD) system in patients with a personal history of breast cancer and to evaluate how the kinetic features affect the performance of two radiologists. MATERIALS AND METHODS: Between 1 January 2014 and 31 December 2017, 3,834 breast MRI examinations in 2,310 patients with a history of breast cancer comprised the study population. MRI images were reviewed retrospectively by two radiologists. First, two radiologists independently reviewed T1-weighted images scanned at 90 seconds after the contrast medium injection and T2-weighted images. After 6 months, the two readers reviewed contrast-enhanced T1-weighted images with five consecutive delayed images using CAD. The diagnostic performance of the abbreviated-sequence and full-sequence MRI were compared. RESULTS: Fifty-one intramammary recurrences were detected with breast MRI in 47 patients. Of the 51 tumour recurrences, 36 (70.6%) lesions occurred >3 years after initial cancer surgery and seven (13.7%) lesions at <2 years after initial surgery. The sensitivity and specificity were 92.2-94.1% and 97.6-98.6% on the abbreviated sequence and 94.1-96.1% and 97.9-98.3% on the full diagnostic MRI. Of 51 malignant lesions, six showed delayed persistent pattern, of which three lesions were non-mass enhancement and three lesions were small enhancing masses <1 cm. CONCLUSION: Overall diagnostic performances of abbreviated MRI and full diagnostic MRI were similar in both readers. The CAD-generated kinetic features could affect reader performance and the sensitivity could be improved or the specificity improved according to the reader.
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Neoplasias da Mama/diagnóstico por imagem , Diagnóstico por Computador , Imageamento por Ressonância Magnética/métodos , Recidiva Local de Neoplasia/diagnóstico por imagem , Neoplasias da Mama/terapia , Carcinoma in Situ/diagnóstico por imagem , Carcinoma Ductal de Mama/diagnóstico por imagem , Carcinoma Lobular/diagnóstico por imagem , Meios de Contraste , Feminino , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
This study aimed to investigate Korean nurses' level of knowledge, attitude, and performance of pressure ulcer prevention in long-term care facilities. A descriptive study was performed. Convenience sampling was used, and registered nurses were recruited from the attendees of a continuing education programme for nurses in long-term care facilities. A total of 282 participants (RN) completed the questionnaire. Data were collected from September to December 2015. Nurses participating in this study demonstrated a moderate level of knowledge of pressure ulcer prevention (60.1%) and exhibited positive attitudes towards pressure ulcer prevention (33.80 ± 2.48). Nurses regularly assessed the risk factors of pressure ulcers during the hospitalisation period for all patients in the hospital when performing pressure ulcer prevention care. However, the plan for preventive nursing care was not properly reviewed. It was also found that nurses did not consider changes in the patient's condition as important to why they had to change their nursing plans to prevent pressure ulcer. Therefore, this study suggested that appropriate guidelines, education programmes, and an environment that makes it possible to provide continuing education should be created for nurses to prevent pressure ulcers in Korea's long-term care facilities.
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Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Assistência de Longa Duração/métodos , Recursos Humanos de Enfermagem Hospitalar/psicologia , Úlcera por Pressão/prevenção & controle , Higiene da Pele/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The aims of this randomised controlled study were to determine whether the application of silicone adhesive dressings with standard preventive care would reduce the impairment of skin integrity and to evaluate the subepidermal moisture (SEM) value in anatomical locations to predict impairment of skin integrity. Of the 71 intensive care unit patients enrolled, 35 and 31 were randomly assigned to the intervention and control groups, respectively. The SEM value was measured at each site (the coccyx, sacrum, and both buttocks) repeatedly three times at every dressing change. Collected data were analysed by multivariate linear regression, and least square means analysis was used to compare the SEM value at the sites of pressure injury (PI) and blanching erythema. There were fewer PIs (1 vs 9) and incidences of blanching erythema (5 vs 6) in the intervention group than in the control group (P = 0.006). The SEM value and difference of the SEM value from the initial value was higher in the group with PIs than in the group without PIs (P < 0.0001 and P = 0.001, respectively). There was a statistically significant difference in the incidence of impaired skin integrity between the groups. The SEM value may be an indicator for detecting impairment of skin integrity.
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Bandagens , Cuidados Críticos/métodos , Região Sacrococcígea/fisiopatologia , Silicones/administração & dosagem , Higiene da Pele/métodos , Infecção da Ferida Cirúrgica/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera por Pressão/prevenção & controle , Região Sacrococcígea/lesõesRESUMO
Pressure ulcers result in financial losses, including the cost of unnecessary medical expenses because of extended hospital stays, treatment, and examination. This was a retrospective, observational, methodological study to develop quality indicators related to pressure ulcer development and validate risk adjustment factors for pressure ulcer development. We performed a literature review to develop risk adjustment factors, and an expert group performed a content validity test. To validate risk adjustment factors for pressure ulcer development using electronic medical records, 127 patients admitted to a long-term care hospital in South Korea from June to September 2015 were enrolled in the study. Pressure ulcer risk factors were peripheral vascular disease, end-stage disease, past pressure ulcer history, high risk group for pressure ulcer development, fever, haemoglobin, and albumin (all P < 0.05); only albumin (odds ratio: 0.210, P < 0.001) was significantly associated with pressure ulcer development as an independent risk factor. Further research with a large sample size is needed for the validation of risk adjustment factors. Risk-adjusted quality indicators for pressure ulcer development can be used to evaluate the quality of nursing care and compare outcomes after preventive pressure ulcer care activities or between long-term care hospitals.